Provider Demographics
NPI:1083807077
Name:UNDERWOOD, SHEREEN MARIE (DO)
Entity Type:Individual
Prefix:MRS
First Name:SHEREEN
Middle Name:MARIE
Last Name:UNDERWOOD
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1200 EXECUTIVE PKWY STE 260
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-2199
Mailing Address - Country:US
Mailing Address - Phone:541-683-6236
Mailing Address - Fax:541-683-6650
Practice Address - Street 1:1200 EXECUTIVE PKWY STE 260
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-2199
Practice Address - Country:US
Practice Address - Phone:541-683-6236
Practice Address - Fax:541-683-6650
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-22
Last Update Date:2020-11-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI51010153082084P0800X
ORDO1779342084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry